Urea to creatinine ratio: a forgotten marker of poor nutritional state in patients undergoing hemodialysis treatment

Figures & data

Table 1. Comparison of age groups.

	<65 years, n = 57	≥65 years, n = 23	p
Gender (% females)	59.6	56.5	0.8
Age	52 (17)	70 (9)	<0.001
Malnutrition (%)	8.8	13	0.68
Malnutrition risk (%)	35.1	26.1
Normal nutritional state (%)	56.1	60.9
MNA-screening score	13 (4)	12 (4)	0.5
MNA-total score	24 (3.5)	24 (5.5)	0.97
Diabetes mellitus (%)	15.8	26.1	0.29
Depression (%)	22.8	30.4	0.48
Depression score	10 (11.5)	10 (13)	0.8
Antidepressant use* (%)	38.5	28.6	1
Anxiety (%)	14	13	1
Anxiety score	8 (11.5)	9 (12)	0.6
HD duration (years)	4.75 (7.75)	4 (7.5)	0.1
Medication number	6 (2.5)	5 (4)	0.3
Waist circumference (cm)	96.3 ± 15.9	98.4 ± 17.9	0.5
BMI (kg/m^2)	25.1 ± 4.5	25.1 ± 3.2	0.98
Albumin (g/dl)	3.8 ± 0.5	3.6 ± 0.6	0.09
C reactive protein (mg/l)	1.2 (3.46)	0.9 (1.56)	0.8
Urea (mg/dl)	115 (84.1)	119 (52)	0.5
Creatinine (mg/dl)	8 ± 2.1	6.7 ± 2.1	0.02
UCR	14.3 ± 6	18.6 ± 7.1	0.007
Kt/V ratio	1.5 (0.63)	1.4 (0.5)	0.2
Hemoglobin (g/dl)	11.6 (1.6)	10.5 (2.2)	0.001
Phosphorus (mg/dl)	4.9 ± 1.3	4.4 ± 1.7	0.1
Ferritin (ng/ml)	1043 (1399)	1114 (1467)	0.5

HD, hemodialysis; BMI, body mass index; UCR, urea/creatinine ratio.

*Antidepressant use among patients with depression according to Beck depression scores.

Table 2. Comparison of nutritional state groups.

	Malnutrition (n = 8)	MR (n = 26)	NND (n = 46)	p
Age	57.3 ± 21.7	54.5 ± 14.8	55.8 ± 12.9	0.87
Gender (%females)	62.5	73.1	50	0.16
Depressive (%)	62.5	34.6	13	0.005
Depression score	17 (14)	14.5 (15.5)	9 (9.25)	0.003
Antidepressant use* (%)	20	44.4	33.3	0.65
Anxiety (%)	25	23.1	6.5	0.09
Anxiety score	14 (18.75)	11 (11.75)	6 (10)	0.004
Diabetes mellitus (%)	12.5	26.9	15.2	0.4
HD duration (years)	1.5 (5.125)	4 (9.5)	4.75 (6.25)	0.18
Medication number	5.5 (2.75)	7 (2.75)	5.5 (3)	0.35
Waist circumference (cm)	83.5 (23)	93 (18.75)	103 (14.25)	0.001
BMI (kg/m^2)	20.5 ± 2.3	24.1 ± 4.1	26.5 ± 3.6	<0.001
Albumin (g/dl)	2.9 ± 0.7	3.6 ± 0.4	3.9 ± .4	<0.001
C reactive protein (mg/l)	5.8 ± 7.7	4.8 ± 10.1	4.9 ± 9.8	0.97
Urea (mg/dl)	124.6 ± 34.5	119.8 ± 49.7	110 ± 51.5	0.6
Creatinine (mg/dl)	6.8 ± 1.6	7 ± 1.9	8.1 ± 2.2	0.045
UCR	18.4 ± 3.5	17.3 ± 7.8	13.8 ± 5.7	0.013
Kt/V ratio	1.3 (0.3)	1.57 (0.6)	1.57 (0.6)	0.13†
Hemoglobin (g/dl)	11 ± 1.8	10.8 ± 1.6	11.2 ± 1.4	0.56
Anemia (%)‡	62.5	60	52.2	0.6
Phosphorus (mg/dl)	4 ± 1.7	4.9 ± 1.7	4.8 ± 1.1	0.28
Ferritin (ng/ml)	1405.5 (1472)	869 (1462.5)	1056 (1284)	0.77

HD, hemodialysis; BMI, body mass index; UCR, urea/creatinine ratio; MR, malnutrition risk; NNS, normal nutritional state.

*Antidepressant use among patients with depression according to Beck depression scores.

†No significant difference between MR and NNS groups, and a significant difference between malnutrition and NNS groups (p = 0.04).

‡A hemoglobin level of <11 g/dl for women and <12 g/dl for men.

Table 3. Comparison of subjects under and not under antidepressant treatment.

	Under ADT	Not under ADT	p
Age	57.1 ± 11.6	55.6 ± 15.2	0.72
Gender (%females)	66.7	59	0.59
Depression (%)	46.7	21.3	0.046
Depression score	14 (18)	9.5 (11)	0.1
Anxiety (%)	13.3	13.1	1
Anxiety score	11 (12)	8 (12)	0.56
HD duration (years)	1.5 (5.125)	4 (9.5)	0.48
MNA score	24.5 (6)	24 (3.4)	0.96

HD, hemodialysis; BMI, body mass index; ADT, antidepressant treatment; HT, hemodialysis treatment; MNA, mini nutritional assessment.